Organization
KHANNA PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANISHA KHANNA D.O. (PHYSICIAN)
(973) 748-6470
Entity
Organization
Contact information
Practice address
401 RIDGEWOOD AVE, GLEN RIDGE, NJ 07028-1512
(973) 748-6470
(973) 748-1834
Mailing address
401 RIDGEWOOD AVE, GLEN RIDGE, NJ 07028-1512
(973) 748-6470
(973) 748-1834
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MB08137900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0182796
—
NJ
Enumeration date
01/23/2009
Last updated
01/23/2009
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